Hi, welcome back. Today we will talk on the psychological first aid application in families with multiple problems. The family with multiple problems concept appeared for the first time in 1950s. The first ones to use it were social workers in England and they referred to families with low socioeconomic characteristics. The criteria to define them aren't established, but all the definitions are focused in these families' lacks. The common factor in families with multiple problems is the presence of problems in all their familiar working areas. Here you can see some examples of a family with multiple problems. Also these families are unable to properly make the management and organization of some tasks such as their sons' education, the protection of the weakest members or the ones with more difficulties, an economical support, the conflicts management, emotional protection or emotional nutrition of the youngest ones of the family, etc. Families with multiple problems aren't exclusive from poor environments, with restrictions and marginality. We can find them in any social, cultural and economical context. However if we add the poor concept to the family with multiple problems, massive consequences for these families' members become structural and hard to modify. Families with multiple problems are characterized for showing up many problems such as alcoholism, drugs consumption, intra-familiar violence in one or more of its members. These families can also be called multi-stressed families or extremely distressed families as they show repetitive crisis at a familiar and individual level. They are families with difficulties and little physical and emotional resources to face this crisis, and they also have multiple conflicts both from their environment and from their own familiar nucleus. These families show a chaotic structure, they are usually rebuilt families, without limits, routines, where it's not clear what they can and what they can't do. Sometimes roles are inverted. In these families there's a dysfunctional communication, a lack of empathy during communication, there's an incongruence between verbal and non-verbal communication and there comes a moment in which language loses its intermediary capacity. In these families with an abandon of parental functions which difficult a safe affection's development. There's an school maladjustment and/or a high school truancy and also the rules and cultural values transmission fails, hindering or stopping social insertion. Finally these families show both an emotional and physical isolation from their large family and from their social and institutional support network. We understand families with multiple problems as families with multiple needs that show a high vulnerability level and an important imbalance between familiar requirements and the resources they have, both their own ones and the social ones. Despite this, families with multiple problems also have competent areas or functioning. These characteristics aren't essential in the family, but the result of the interaction between this family and its environment. They have a high parental replacement, a great flexibility and adaptability capacity, they can mobilize social resources of the formal system and also get other necessary resources from the informal system. Let's now see the types of families with multiple problems we can find: well-structured families are those families which belong to a high socioeconomic class where one or more of its significant members show a chronic disorganized behavior. The absent or peripheral parent refers to the parent who isn't able to influence in the familiar functioning. Young parents or young couples where one or both members show a series of behavior problems, drug addictions or adaptation issues. They have a conflictive and unstable relationship without being able to form a family, and one of them ends up leaving. Women who are alone with one or many children, sometimes from different parents, show an incapacity to keep a lasting and stable emotional relationship. Sometimes these women have had drug addictions or prostitution issues. The absent grandmother appears when the mother with one or more children goes back to her mother's house. The grandmother ends up making a mother role for both her daughter and her grandsons. Finally, petrified families are those families that, after a traumatic sudden incident, can't process the mourning and its structure and its familiar functioning becomes totally altered. In previous videos we already saw which are the objectives of psychological first aid and how to apply them. To work with families with multiple problems we must impose some order and reduce noise, that is, trying to delete those possible interferences that might difficult the situation's management for us. We must make conversation rules specific and clear. Not talking all at once, respecting participation tones, answering questions, listening to what the others say. We must distinguish between the content and the relation components from the messages, which is what is said, who is told that and how it is said. We must make a restructuring of the different familiar levels, that is, distinguishing the familiar nucleus and the large family, the relatives, the friends or the neighbors. And finally we mustn't force to stay anyone who doesn't want to. We must be clear with the kind of help we are going to provide, differentiating it from other services. We must frame the problem within the context, within the multiple resources and systems that are already working with the family. We must limit and focus on the problem and its close aspects, leaving aside other problems that might come out. The objectives we set must be clear and important to the family and we must try to avoid a dependence bond. In families with multiple problems behavior is more important than words. That's why we must give priority to attitudes and behaviors before emotions. In these families it's easier to find out changes in the behaviors than in the opinions and feelings. We must give personal power to each one of its members so that they feel they have control over their behavior and on decision making. We must try to avoid discussions and try to put more limits than they can tolerate. In front of a rage attack, personal attacks or conflicts, we must try to correct them positively as the worry expression on what happened and the rest. We must also try to correct feelings, in example, I understand that in front of this situation you are really angry, but it's neither good for you nor for the rest that you show it up so often. When there are kids and teenagers around, we must avoid replacing adults. What we must do is give them the assistance they need and stimulate their resources.